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Family to Family of Rhode Island

CONTACT INFORMATION

FAMILY TO FAMILY OF RHODE ISLAND Partner Logos - Family Voices, Rhode Island Parent Information Network and Paul V. Sherlock Center on Disabilities
By completing the information below, you are agreeing to act as a Family to Family resource for other families of people with special needs in Rhode Island. The information you provide (unless otherwise indicated) will be published on the Family to Family website (www.rifamilytofamily.net), in the Family Resource Directory, and linked to the RIPIN Facebook page. You have the option to accept phone calls or e-mails from families of people with special needs. You have the opportunity to indicate your areas of personal knowledge and experience.
The fields in this form may be navigated using the "Tab" key or mouse.  Do not press enter until you are ready to navigate to the next page and/or submit your request.
1. Check one: (Changes will be made to the online directory within one week) *This question is required.
Street address will be used for mailing list purposes only. City will be the only address information listed in the directory. 
I am willing to have other families contact me by phone and permit Family to Family of RI to publish my phone number for this purpose.

Your phone number will only be listed in the directory if you check "yes" below. *This question is required.
Preferred time to be contacted by phone:
I am willing to have other families contact me by email and permit Family to Family of RI to publish my email address for this purpose.

Your email address will only be listed in the directory if you check "yes" below. *This question is required.
Language(s) spoken (other than English):
Family Member #1
Family Member #1 - Identify Disability Category/s:
Add another?
Family Member #2
Family Member #2 - Identify Disability Category/s:
Add another?
Family Member #3
Family Member #3 - Identify Disability Category/s:
Add another?
Family Member #4
Family Member #4 - Identify Disability Category/s:
Do you belong to any groups or organizations or participate in any activities that relate to people with special needs and their families?
Note: You can retract or update this information at any time by completing a new electronic form or by calling or emailing Family Voices at RI Parent Information Network, 401-270-0101, x139, townsend@ripin.org.
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